A Case of the Week
Case 220
An eighty one-year-old male presented in our hospital with a referring letter and laboratory data from a local clinic. It said high fever and high values of CRP 29.7 mg/dL, white blood cells 16940/mm3, neutrophils 89%, total bilirubin 2.63mg/dL, AST 104 U/L, ALT 52 U/L, choline esterase 119 U/L, BNP 618pg/dL. He was a heavily-alcohol drinker with strong whisky 180 mL /day. Under suspicious biliary duct inflammation, our clinician asked him to take abdomen CT at admission (Figs 1, 2). The following day, he took lumbar vertebra MRI (Figs 3-6) for further investigation.
What is your diagnosis ?
2021.2.3
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